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PROJECTS TO IMPROVE ACCESS TO HEALTHCARE

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Pilot projects are to be set up in three NHS board areas in order to improve access to healthcare for those in Scot...
Pilot projects are to be set up in three NHS board areas in order to improve access to healthcare for those in Scotland's poorest communities, health minister Malcolm Chisholm announced today.

The pilots, backed by£15m investment over the next two years, will look at ways of addressing such issues as access to treatment for major diseases like chronic heart disease and the uptake of screening and prevention services which is much lower in the most deprived areas compared to the most affluent areas of Scotland.

Three NHS board areas, with the highest concentrations of deprivation in Scotland, are to benefit from the funding - NHS Greater Glasgow will receive£4m in 2004/05 and£8m in 2005/06 and NHS Tayside and Argyll & Clyde will both receive£0.5m in 2004/05 and£1m in 2005/06.

The pilots follow the research report on unmet need from John Arbuthnott's standing committee on resource allocation. This report concluded that there is clear evidence that people living in the most deprived areas of Scotland are less likely to access healthcare services than people from the most affluent areas. It pointed out that this has implications for the way that resources are allocated between NHS Boards and recommended that an adjustment to take account of this should be included in the Arbuthnott formula.

Announcing the funding the minister said:

'We have the evidence to show that those in the most deprived areas are not accessing healthcare services at the same rate as their most affluent neighbours.

'This means that those communities most needing help, whether that is screening or immunisation or treatment for ill health, are not receiving as much as they should. These are the very communities, blighted by chronic disease over so many years, that need our help the most.

'Sir John's committee has recommended that a further adjustment should be made to the resource allocation formula to take account of unmet need in the most deprived a reas. However, before we decide on this we need to examine how additional funding can be used to improve access to health services by people from the most deprived areas.

'We want to see innovative ideas for addressing unmet health needs and an improvement in access to NHS services by people living in our most deprived communities. This is one way in which the NHS can contribute both to improving health in general and, more importantly, tackle Scotland's health inequalities.'

While it will be up to the NHS boards concerned to determine the pilot projects, they will be required to provide plans to the executive for carrying out the pilot studies before the funding is released. The pilot studies will be evaluated and monitored.

Some examples of unmet need include:

* Access by people with chronic heart disease (CHD) living in deprived areas to a range of services - coronary artery by-pass grafts, angioplasties and prescribing of statins, is less than would be expected in deprived areas given the high known rates of CHD in these areas;

* Attendance rates at breast screening clinics is much higher in women from relatively affluent areas compared with women from the most deprived areas;

* Uptake rates of the winter flu vaccination scheme is much higher in people from relatively affluent areas.

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